1. Field of Invention
An accurate diagnosis of the condition of a patient is the foundation upon which an appropriate medical treatment stands. Medical imaging is often indispensable in the process of diagnosing and monitoring medical treatment for pathologies and injuries. The diagnostic value of any medical imaging exam is greatly influenced by the competence of the technologist performing it. Over the last few decades, major advances have been made in medical imaging that enable accurate diagnoses to be faster, less invasive, and more cost effective. For radiologists, the workload is not only increasing in the number of exams, but exams are also growing in complexity with the advances in imaging capabilities. It is now being used to assess both anatomy and physiology in patients. The need for exams to be performed correctly the first time cannot be overstated.
Because of these technology improvements, and an aging population, the demand for medical imaging services has increased dramatically creating a shortage of both radiologists and experienced imaging technologists to meet this demand. Radiology workloads are significantly increasing in both volume and complexity. Demands are increasing for more technologists. This demand results in less time and interaction for on the job training and improvement. Further complicating the interaction are the many remote sites for testing at local clinics and specialty test facilities. Satellite sites result in having radiologists often being distant from the technologist during the “reading” of the image. Then, the radiologist may have only an “image” to evaluate and little or no direct input from the technologist that performed the test.
In response to the increasing demand, the latest computer technologies for connectivity are being employed to increase workflow efficiencies. Picture Archiving and Communications Systems (PACS) are being integrated with Radiology Information Systems (RIS) so that images, along with their interpretive reports, patient demographics, and previous exams, can be quickly and easily accessed by radiologists and referring physicians. Often the PACS and RIS are connected to the health care facility's own information system (HIS). While these technologies greatly enhance the communication process, they are not yet being utilized to their full potential.
Modalities is the commonly used term for classification or type of medical and diagnostic imaging tests in the health care industry. Examples and not limitations of key modalities that are completed by medical imaging technologists in preparation for a radiologist to “read” and analyze are as follows:                a. X-ray digital or conventional film        b. CR—Computed Radiograpy        c. CT—Computer Tomography (formerly CAT—Computer Axial Tomography)        d. MRI—Magnetic Resonance Imaging        e. US—ultrasound        f. Mammography—        g. NM—Nuclear Medicine        
A. Introduction of the Problems Addressed
All of the medical imaging modalities require professionals who must be able to use available technology and elicit patient co-operation in order to perform the exam. Technologists must have a good understanding of: the anatomy being imaged, the physics being used to generate the image, and the effects of pathology on the image. They must be able to evaluate the diagnostic quality of the images as the test or exam is being performed. This is a crucial point in the medical imaging process. When image quality is compromised, the technologist must quickly recognize the inadequacy and determine its source. They must then eliminate the cause, or moderate its effect, and repeat the view or imaging sequence as necessary. Proficiency in overcoming these obstacles is vital, especially within the context of tight examination schedules.
A critical need for exams to be performed correctly the first time cannot be overstated. Failure to do so can result in missed diagnoses due to compromised exams. If the patient must be asked to return for a repeat of the exam, it is a hardship for the patient and an expense to the health care provider. Other consequences include delays in report turnaround and increased liability exposure to the medical personnel and facilities.
A shortage of technologists means that there are many young and less experienced technologists being relied upon to make good decisions on a consistent basis even in a difficult work environment. In the past, radiologists have been able to instruct technologists and help them continually learn from their good and bad decisions; however, with the increased workloads that radiologists are experiencing and the tighter exam schedules that technologists are managing, there is less time for this kind of interaction. Communication between technologists and radiologists is further diminished by the increase in the number of exams being performed in outpatient facilities. Many radiologists have never met some of the technologists who submit exams to them for interpretation.
This dilemma and problem as described above is where experienced management must rise to meet and overcome the challenge. Radiologists are increasingly dependent upon management to communicate with the technologist when exam quality is compromised. Educators are doing all they can to produce qualified technologists; however, there is no substitute for experience and ongoing instruction. Technologists need constructive feedback on the quality of their work on a continual basis. Technologists also need accountability for the decisions they make. The sheer volume of exams and the dispersion of imaging locations make this a formidable task for management.
2. Prior Art
Historically, the prior art business methods to assess and improve quality for medical imaging have addressed few of these needs. Importantly, never has any prior art provided a solution in one system or method to virtually address all the above stated problems.
Examples of prior methods and apparatus to improve modern medical images begin with U.S. Pat. No. 5,655,084 issued to Pinsky, et al. (Aug. 5, 1997). This teaches an apparatus to convert medical images into a digital in order to transfer them to remote facilities. No mention of a system for improving the capability of the technologist or feedback from the radiologist to supervisor is addressed. A year later, another monitoring system patent was issued to Friz, et al. under U.S. Pat. No. 5,786,994 (Jul. 28, 1998). This patent taught a monitoring system to record errors and problems with a specific imaging machine or device. This data was then used to improve equipment maintenance in order to improve quality of the image. No technologist data or feedback was mentioned.
Other examples of data manipulation art for health facilities include a publication U.S. 2001/0032101 A1 provided by Statius Muller (Oct. 18, 2001). This teaches and describes a specific way to manage and store specific data on patients and an ability to retrieve the data rapidly. Again there lacks any discussion of using the data to improve the quality derived from individual technologists or departments. Another publication U.S. 2001/0051881 A1 provided by Filler (Dec. 13, 2001) teaches a system and method to transfer data from one location where a test or image was created to a remote location where a professional, such as a radiologist, might interpret the image. There is no mention of recording the image quality and potential causes of poor quality and relate that back to quality assessment and improvement for the technologist that created the image. A U.S. Pat. No. 6,353,802 issued to Barbur et al. (Mar. 5, 2002) teaches basic reject analysis through data gathering and statistical manipulation. This does reference radiology and photo processes but does not establish or provide any business method to incorporate the results into an improvement system involving the radiologist, technologist and supervisor. It is important for one to note that the radiologist's input is not required in this prior art. The new QAISys provides the methodology of taking any statistical data and creating a rating and manner to provide improvement to the human factors in the whole medical imaging business.
Another medical imaging system performance improvement tool is taught in publication U.S. 2002/0082864 A1 provided by Kelley et al (Jun. 27, 2002). This tool focuses on the equipment used and tracking of image quality. There is no discussion of the technologist's role in the medical imaging quality in respect to using any data to improve the technologist's capability. The publication U.S. 2002/0085026 A1 provided by Bocionek et al.(Jul. 4, 2002) is the pure data collection system in the radiology section of a health facility. This system now known as the Radiology Information System (RIS) primarily matches patient, doctor and imaging data into one system for convenient and rapid computer monitor access by medical personnel. The system permits text and image access and inputs but does not teach a technologist quality improvement system.
The publication U.S. 2002/0131625 A1 provided by Vining et al. (Sep. 19, 2002) teaches an intermediate comment or expert opinion from professional medical personnel such as radiologists and other medical doctors. This is supplemental to the Picture Archival and Communication System (PACS) and provides input to both the Radiology Information System (RIS) and Hospital Information System (HIS). While this may complement the new QAISys presented here, it does not teach or imply the use of the data inputted to improve the quality of the technologists' efforts. Another publication concerning a medical image improvement is a system taught by U.S. 2002/0194019 A1 by Evertsz (Dec. 19, 2002). This system teaches the use of known and unknown diagnosed problem case correlated and tested to determine if a radiologist could or has made a misdiagnosis. Technologist improvements are essentially not addressed.
The U.S. Pat. No. 6,574,304 B1 issued to Hsieh et al. (Jun. 3, 2003) teaches a computer aided system that takes existing medical images, analyzes the results by computer, re-determines if other concerns present themselves in addition to the original diagnosis, and even suggests the need for additional images. No technologist improvement data is suggested or taught. The U.S. Pat. No. 6,574,629 B1 issued to Cooke, Jr. et al. (Jun. 3, 2003) teaches the Picture Archiving and Communication System (PACS). This system is used to collect and present medical images but stops short of teaching its use of data collected to enhance technologists' capability.
The publication U.S. 2003/0212580 A1 provided by Shen (Nov. 13, 2003) teaches a system to manage the information flow within the medical imaging process. The publication discusses interfaces of the system and mentions analysis of organization performance, but does not elaborate on this in the description. Additionally, no claims for improvement to technologist's capabilities are provided. The publication U.S. 2004/0015372 A1 provided by Bergman et al. (Jan. 22, 2004) teaches a process to collect data in the medical information systems. It elaborates on patient and results information and statistical comparisons. It does not teach or claim using the data for improving capabilities and quality enhancement of the technologists in the medical image field.
None of the above described prior art teaches all the features and capabilities of the QUALITY ASSESSMENT and IMPROVEMENT SYSTEM (QAISys) in MEDICAL IMAGING.